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The Diary of a CEO with Steven Bartlett · June 22, 2026 · 1h 47m

Dr Rachel Rubin: Women’s Sexual Health, Menopause, Hormone Replacement Therapy (HRT), and Orgasms!

Dr Rachel Rubin

Sexual medicine specialist Dr. Rachel Rubin explains why women's sexual health is widely neglected, from testosterone deficiency to overlooked clitoral anatomy. She discusses how birth control, antidepressants, and GLP-1 drugs affect libido, the flawed history of hormone therapy and cancer scares, and the physical conditions that prevent orgasm in one in four women. The conversation also covers pelvic floor dysfunction, perimenopause starting earlier than expected, and practical paths to building a medical team that actually listens.

This summary was generated from show notes and public descriptions, not from a full transcript review. Details may contain inaccuracies.

Canon

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The Overcorrection on Hormone Therapy and Cancer Risk00:27:27
The 2002 WHI study that scared women away from hormone therapy was overstated, and the FDA recently removed the boxed warning.
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Highlights

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The Neglect of Women's Sexual Health00:00:00
Most doctors lack any training in women's sexual health, so complaints about pain or low desire are frequently dismissed.
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Testosterone Is Crucial for Female Libido00:11:32
Testosterone is not just a male hormone; it drives sexual desire in women and is rarely tested or treated.
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How Hormonal Birth Control Affects Desire00:13:41
Oral contraceptives can suppress libido by altering hormone levels and binding up testosterone.
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Clitoral Anatomy and Hidden Physical Barriers to Orgasm00:07:02
Even gynecologists receive next to no education on clitoral anatomy, missing treatable conditions that prevent orgasm.
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Tight Pelvic Floor as Hidden Cause of Sexual Pain
Pelvic floor tightness is a common, treatable source of pain during sex that most doctors never diagnose.
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Misc

✧Only about 80 doctors in the US are trained to treat both male and female sexual health.
✧An estimated one in four women have a physical barrier to orgasm that most doctors never check for.
✧Dr. Rubin helped drive the FDA's removal of the boxed warning on menopausal hormone therapy.
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